Network Reimbursement Specialist
About The Position
The Network Reimbursement Specialist is responsible for the implementation, coordination and maintenance of all routine provider reimbursement updates, including updates to professional and allied fee schedules, updates to facility reimbursement rates, pricing rule changes, and the development, execution and completion of test plans and related claims testing when implementing new or modifying existing reimbursement functionality. The Network Reimbursement Specialist is required to be (or become) the subject matter expert in Network reimbursement as it pertains to the functionality within the medical claims processing system. This position also serves as a technical consultant for medical claim reimbursement related inquiries received from other departments or external sources.
Requirements
- Bachelor’s degree required.
- Logical thought process in order to interpret and apply contract benefits.
- Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality.
- Good analytical skills and proven ability to independently research, document and present solutions to problems.
- Strong documentation and organizational skills required.
- Strong interpersonal, communication and facilitation skills required.
- Ability to multi-task and handle concurrent projects.
- Knowledge of Microsoft Excel and Word is required.
Responsibilities
- Implementation, coordination and maintenance of all routine provider reimbursement updates, including updates to professional and allied fee schedules, updates to facility reimbursement rates, pricing rule changes.
- Development, execution and completion of test plans and related claims testing when implementing new or modifying existing reimbursement functionality.
- Serve as the subject matter expert in Network reimbursement as it pertains to the functionality within the medical claims processing system.
- Serve as a technical consultant for medical claim reimbursement related inquiries received from other departments or external sources.
Benefits
- Comprehensive benefits package that is worth approximately one-third of the salary compensation.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
